Accumulation of Methane, Acetone, and Nitrogen in the Inspired Gas during Closed-Circuit Anesthesia

Abstract

During closed-circuit anesthesia, the patient's inspired gas may become progressively contaminated by nonanesthetic gases. We studied the concentrations of methane, acetone, and nitrogen as nonanesthetic gas contaminants in the circuit gas of 16 cases during closed-circuit anesthesia. After a “short” period of denitrogenation (6–8 min), average nitrogen concentration in the closed circuit increased from 6.4 to 16.2%, methane from 4.3 to 22.4 ppm, and acetone from 0.3 to 2.2 ppm. After “long” denitrogenation (33 min), average nitrogen concentration in the closed circuit increased from 1.0 to 5.1%, methane from 3.7 to 17.9 ppm, and acetone from 1.3 to 5.9 ppm. It is concluded that gases stored in tissues or produced within the body can appear in the patient's expired gas during closed-circuit anesthesia. Intermittent flushing of the circuit with high flow gases is suggested to remove these contaminants.